Chronic pain is pain that has continued for more than six months, despite medical attention. It might have an organic cause, such as injury, chronic illness, or arthritis, or there may be no identiﬁed cause. It always involves complex physical and psychological components. The psychological factors are more signiﬁcant if there is no identiﬁed cause because the patient is likely to be accused of being a malingerer or a hypochondriac.
Treatment of chronic pain must consider the interplay of physical and psychological components. The traditional approach to chronic pain is to supply analgesic (painkiller) drugs. These medications work reasonably well for acute or temporary pain, because by the time you develop a tolerance for the drug, the pain may be gone. For chronic pain, however, there is an inherent trap. The relief given by the narcotic diminishes as tolerance builds, and withdrawal of the drug intensiﬁes the perception of the pain beyond what it would have been if the drug were never given. Nonnarcotic analgesics like aspirin provide relief only up to a certain point, and are not very helpful with chronic pain.
People with chronic pain often have below-normal levels of natural analgesic neurotransmitters, like endorphins and enkephalins. Many approaches to chronic pain appear to increase the efﬁciency of the body’s own pain relief system, usually by making available more of the opioid neurotransmitters, or enhancing their use. The following are some strategies that have shown promise in dealing with chronic pain:
Relaxation Deep relaxation techniques, hypnosis, biofeedback, and meditation can relax muscles and ease anxiety, thereby reducing chronic pain.
TENS Transcutaneous electrical nerve stimulation (TENS) is a technique using a portable device that produces weak electrical currents near the area of discomfort. The patient feels a mild tingling sensation that blocks the body’s pain signals, providing immediate relief.
Acupuncture The ancient Chinese technique of acupuncture places ﬁne needles into carefully selected points on the body. Studies show pain-relief beneﬁts for 26 to 79 percent of back pain patients. The mechanism for its success is not well understood, and is controversial, but probably affects the opioid neurotransmitter balance, either directly or through placebo effects.
Exercise Physical activity helps many chronic pain patients. Swimming is especially helpful. Walking and riding a stationary bicycle are commonly used. The exercise can improve overall conditioning, relieve stress, and increase the sense of well-being. If rigorous, it can also release endorphins and enkephalins.
Pain clinics There are now hundreds of pain clinics across the United States. The best are staffed with multidisciplinary teams that include neurologists, physical therapists, social workers, nurses, psychologists, and others. Their treatment programs include psychological and physical rehabilitative techniques.
Resources for chronic pain information include:
Chronic Pain Outreach Center, Inc.
12320 Parklawn Drive
Rockville, MD 20852
Addiction People who become addicted to pain medications need special attention. Regular drug addiction programs seldom deal with chronic pain. Some pain clinics may not be equipped to deal with addiction. Both issues need to be addressed. Even after detox, these patients need to learn to deal with their pain.
To deal with the addiction and emotional aspects, try Narcotics Anonymous, Emotions Anonymous, or other Twelve-Step groups. If pain medication is a strong addiction, you may want to contact:
Pills Anonymous (PA)
Chronic pain, see also: Addiction, Alcohol, Biochemistry, Constipation, Drugs, Exercise & activity, Family, Moodifiers, Narcotics Anonymous, Nutrition, Obesity, Prevention of addiction, Stress & strain, Unmanageability.
Updated 7 Sep 2015
Addictionary 2 by Jan & Judy Wilson
is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.